June 16, 2010

Payment Policy Based on Measurement of Health Care Spending and Outcomes

Author Affiliations

Author Affiliations: Strategy Area, The Fuqua School of Business, Duke University, and Department of Community and Family Medicine, Duke School of Medicine, Durham, North Carolina; and Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill.

JAMA. 2010;303(23):2405-2406. doi:10.1001/jama.2010.817

Measuring variation in spending and outcomes is a critical component of reforming physician and hospital payment policy. Analysis of area and hospital variations has a storied history1 and is increasingly common in media reports.2 If higher spending does not lead to better outcomes, health care could be delivered far more cost-effectively. But if approaches to measuring costs and outcomes are flawed, reductions in spending might yield worse outcomes.

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